基于“虚邪瘀”理论的强直性脊柱炎中医证候规范化研究

发布时间：2018-12-11 00:34

【摘要】：目的：借助临床流行病学的方法，将强直性脊柱炎的临床信息进行收集整理，利用相关统计学方法从“虚邪瘀”理论角度分析强直性脊柱炎的中医证候特点，初步建立基于“虚邪瘀”理论的强直性脊柱炎中医证候分类及辨证标准，为临床强直性脊柱炎的中医药治疗和研究提供依据。方法：通过检索相关文献、阅读专著、咨询专家和预调查等方法,设计强直性脊柱炎临床信息调查表,对2013年4月至2013年12月在河南风湿病医院首次门诊及住院的206例强直性脊柱炎患者进行临床流行病学调查,最后将收集的资料输入数据库，采用SPSS19.0统计软件进行数据处理，运用描述性分析、频数分析、因子分析和聚类分析等统计方法,从“虚邪瘀”理论角度分析强直性脊柱炎的中医证候特点，初步建立基于“虚邪瘀”理论的强直性脊柱炎中医证候分类及辨证标准。结果：1.纳入本次研究的强直性脊柱炎患者共206例，其中男性患者174例，女性患者32例，男女比例约5.4：1。患者的发病年龄主要集中在10岁到30岁之间且病程较长以2年到20年居多，发病原因多为劳累、受风寒湿和外伤，首次发病季节多在夏季和冬季。2.简化数据缩减变量后，经因子分析得到8个符合中医证候诊断的公因子，它们基本反映了强直性脊柱炎的病因病机。聚类分析将变量聚为3类，，结合因子分析所得到的8个公因子并运用“虚邪瘀”理论将强直性脊柱炎的中医证候分为3类：第1类肾阴虚内热、湿瘀痹阻证；第2类邪瘀痹阻、肾虚肝郁证；第3类肾阳虚寒凝、瘀血阻络证。结论：本研究在“虚邪瘀”理论的指导下，采用因子分析和聚类分析等统计学方法，从“虚邪瘀”理论角度将强直性脊柱炎的中医证候分为3类：第1类肾阴虚内热、湿瘀痹阻证；第2类邪瘀痹阻、肾虚肝郁证；第3类肾阳虚寒凝、瘀血阻络证。
[Abstract]:Objective: to collect and organize the clinical information of ankylosing spondylitis by means of clinical epidemiology, and to analyze the characteristics of TCM syndromes of ankylosing spondylitis from the theory of "deficiency and evil stasis". To establish the TCM syndrome classification and syndrome differentiation standard of ankylosing spondylitis based on the theory of "deficiency pathogenic stasis", and to provide the basis for the treatment and research of clinical ankylosing spondylitis with traditional Chinese medicine. Methods: a questionnaire for clinical information of ankylosing spondylitis was designed by searching related literature, reading monographs, consulting experts and pre-investigation. From April 2013 to December 2013, 206 patients with ankylosing spondylitis who were first outpatient and hospitalized in Henan Rheumatological Hospital were investigated by clinical epidemiology. Finally, the collected data were input into the database, and the data were processed by SPSS19.0 software. By means of descriptive analysis, frequency analysis, factor analysis and cluster analysis, the characteristics of TCM syndromes of ankylosing spondylitis were analyzed from the theory of "deficiency and evil stasis". To establish the TCM syndrome classification and syndrome differentiation standard of ankylosing spondylitis based on the theory of deficiency and evil stasis. Results: 1. A total of 206 patients with ankylosing spondylitis were included in the study, including 174 men and 32 women, with a ratio of 5. 4 to 1. The onset age of the patients was mainly between 10 and 30 years of age and the course of disease was longer than 2 to 20 years. The most common cause was fatigue, wind, cold, dampness and trauma, and the first onset season was mostly in summer and winter. After simplified data reduction variables, eight common factors were obtained by factor analysis, which reflected the etiology and pathogenesis of ankylosing spondylitis. Cluster analysis divided variables into three categories, combined with the eight common factors obtained by factor analysis and the theory of "deficiency and evil stasis", the TCM syndrome of ankylosing spondylitis was divided into three categories: the first type of kidney yin deficiency internal heat, dampness stasis obstruction syndrome; Type 2, stagnation of pathogenic stasis, kidney deficiency and liver stagnation syndrome, the third type of kidney yang deficiency cold coagulation, blood stasis blocking collaterals syndrome. Conclusion: under the guidance of the theory of "deficiency and evil stasis", this study used factor analysis and cluster analysis to classify the TCM syndromes of ankylosing spondylitis into three categories: type 1, internal heat of kidney yin deficiency, and so on, from the perspective of "deficiency of pathogenic blood stasis" theory, the TCM syndromes of ankylosing spondylitis can be divided into three categories. Syndrome of dampness and stasis obstruction; Type 2, stagnation of pathogenic stasis, kidney deficiency and liver stagnation syndrome, the third type of kidney yang deficiency cold coagulation, blood stasis blocking collaterals syndrome.
【学位授予单位】：河南中医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R259

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